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Cultural traditions carry American Indians, Alaska Natives through COVID-19 — and create risks

Cultural traditions carry American Indians, Alaska Natives through COVID-19 — and create risks

Picture of Joaqlin Estus
A nurse takes a swab sample from a Navajo Indian woman complaining of virus symptoms at a COVID-19 testing center at the Navajo
A nurse takes a swab sample from a Navajo Indian woman complaining of virus symptoms at a COVID-19 testing center at the Navajo Nation town of Monument Valley in Arizona in May.
(Photo by Mark Ralston/AFP via Getty Images)

As tribes confront some of the highest rates of COVID-19 infections and deaths in the country, they are finding strength and solutions in culture and tradition.

“We do have the answers, the solutions to many and maybe all of our problems in Indian country if we just dig deep into our teaching and into our culture and our tradition and our language,” Navajo Nation President Jonathan Nez said recently at the National Indian Health Board annual conference.

The Navajo reservation endured one of the worst COVID-19 outbreaks in the United States, with 35.5 cases per 1,000 people in June. Tribal leaders incorporated characters and symbols from ancient myths into a public health campaign that helped turn the crisis around.

Two of the most important characters in Navajo stories about human origins are the hero twins, sons of the first woman who are beset by human-killing monsters during a journey.

When the fearsome monsters appear in the tale, “we were taught that we have weapons and we have the armor to combat these monsters,” Nez said.

“So as we started messaging and preparing our Navajo people for this virus to come into our nation back in March, early April, we framed it in that way, that we need to be equipped with the weapons to combat this modern-day monster, COVID-19.”

Nez continues to deliver that message. “Wearing a mask makes you a warrior, because you're helping to protect your people. And you're actually saving lives whether you know it or not.”

The Navajo Nation, which stretches across parts of Arizona, Utah and New Mexico, has about 200 contact tracers who identify people who need to quarantine because they have been exposed to the coronavirus. That effort, combined with health education and restrictions such as curfews, brought the new case count from a high of 240 a day in June to a low of one case on Sept. 7.

As restrictions were lifted, however, the numbers began to rise. Cases are surging again along with alarming increases in much of the country. “We strongly urge everyone to take precautions and to keep their guard up,” Nez said. The tribe has clamped down again with nightly and weekend curfews.

Nez acknowledged that one Navajo strength — strong community and family ties — is creating risk.

“We have now seen that much of the spread here on the Navajo Nation is because of family gatherings,” he said. “As Native people, we are by nature social and our communities are close-knit, and you can see that evident with the spread of COVID-19 in these tight-knit communities.

“We care about our elders. We care about our culture. We care about our tradition. We care about our sports. And ... we want to protect them.” — Tribal Chief Cyrus Ben, Mississippi Band of Choctaw Indians

Gwendena Lee-Gatewood is chairperson of the White Mountain Apache Tribe in central Arizona, which had 64.6 cases per 1,000 residents in early June, and then saw it double in July, to 135.7 cases per 1,000, according to the Arizona Republic.

“We had some challenges of people not wanting to wear a mask, that they felt they were a weaker individual,” Lee-Gatewood said. “And it took a lot of working to promote that you're not only protecting yourself, but you're also protecting others. And in order for us to make it through this pandemic, you have to work together and we have to protect our elders.”

Of the tribe’s population of more than 17,000, only 200 people are 80 or older. They’re cherished for the knowledge they pass on about Apache culture, language and way of life through school programs and informally.

Lee-Gatewood said her tribe exercised its sovereignty and imposed some of the strictest measures anywhere to control viral spread, with penalties for noncompliance. People could not leave home except for an emergency or if they had employer documentation to prove they were an essential worker. The tribe closed its borders to outsiders.

It also provided a strong support system, using rooms at the tribe’s casino hotel to house people who needed to quarantine away from home. And for those who stayed home, “We said, ‘Hey, we'll run your errands for you. We'll come bring you the food. You need prescription refills, we'll have someone go get it for you. We'll bring you cleaning supplies,’” Lee-Gatewood said. 

For people who tested positive for the virus and the people they lived with, the tribe added daily wellness visits. By checking temperature, oxygen levels, hydration and blood sugar, health care providers were able to catch cases at earlier stages, before hospitalization was needed.

“That made them feel more at ease, because they were being taken care of,” Lee-Gatewood said. The number of new cases among the Apache went from dozens per day in late spring and early summer to single digits in September. With 14 new cases on Nov. 4, the rate is creeping up again.

The Mississippi Band of Choctaw Indians has also been hit hard by the pandemic. In July, Choctaw County was recording nearly 38 cases per 1,000 residents when the tribe canceled its annual Choctaw Indian Fair, including a popular stickball tournament. In getting support for the shutdown, the tribe appealed to its citizens’ love for their people and traditions. 

“We stated we canceled our fair because we care. We care about our elders. We care about our culture. We care about our tradition. We care about our sports. And with that ... we want to protect them,” said Tribal Chief Cyrus Ben.

As of Nov. 2, the rate of COVID-19 cases was 15 per 1,000.

The pandemic has disrupted communal rituals around grief and mourning, increasing the anguish of survivors. Normally, the Choctaw hold a two-day wake after a death, Ben said.

“To all of a sudden go from what all we know (are) our cultural and social practices of being together in the loss of a loved one, being able to come together and mourn and pray and cry together, and to be able to have that healing, that was something that we had to change and unfortunately go to only graveside services.”

The pandemic has also brought depression, anxiety and fear. 

Dr. Mary Owen, Tlingit, director of the Center of American Indian and Minority Health at the University of Minnesota Medical School, said people have lost their incomes. Some don’t know if they’ll be able to pay next month’s rent. They’re coping with homeschooling. 

“On top of it all, I think it's that loneliness, of not being able to reach out and touch somebody,” Owen said.

But she sees people finding solace and a sense of community by moving ancient cultural practices to the digital world. Students are teaching powwow dance steps and forming talking circles online. “And that's not ideal for a talking circle. I understand that. But if that helps keep them sane and helps keep them connected, then I'm all for it.” 

As of mid-October, the COVID-19 death rate among Native Americans nationally was 90 per 100,000, compared with 54.4 per 100,000 among white Americans, according to APM Research Lab.

Long-standing systemic health and social inequities drive the disparity, Anthony Fauci, director of National Institute of Allergy and Infectious Diseases, told the Indian health board conference.

He listed contributing factors including discrimination, limited access to health care, occupations that make it hard to avoid infection, housing with multiple generations living in crowded conditions, and gaps in education, income and wealth.

The United States is built on Native land and resources taken with the promise of health care, education and food in exchange. However, Congress keeps a tight fist on spending for Indian health care. The Indian Health Service, the principal federal health care provider for American Indians, is chronically underfunded and most facilities are understaffed, ill-equipped and outdated.

Add to that underlying diseases such as high blood pressure, diabetes, and heart disease, and you get a rate of Native hospitalizations that is 4.4 times that of whites, said Walker River Paiute Tribe Chairwoman Amber Torres.

Still, several tribal leaders said their people are resilient. In an interview with Indian Country Today’s Patty Talahongva, Chairman Devon Boyer of the Shoshone-Bannock Tribes said, “It's hard to look through a dark sky and see some light, but we know it's there.” 

Joaqlin Estus, Tlingit, is a national correspondent for Indian Country Today and a long-time Alaska journalist. As a 2014 USC Annenberg National Health Journalism Fellow and Dennis A. Hunt grant recipient, she produced a radio series on the effects of the lack of running water and flush toilets on the health of the thousands of Alaska Natives living in dozens of underserved rural villages.

CORRECTION: An earlier version of this story misspelled the name of Indian Country Today’s Patty Talahongva.

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